Kuhn Ferenc, Mester Viktória
United States Eye Injury Registry, Helen Keller Foundation for Research and Education, Department of Ophthalmology, University of Alabama at Birmingham, Birmingham, AL, USA.
Ophthalmol Clin North Am. 2002 Jun;15(2):195-203. doi: 10.1016/s0896-1549(02)00010-x.
Material occurring in the anterior chamber as a result of trauma may be of little or major significance. The most common finding requiring treatment is hyphema. Close observation and (often surgical) treatment is especially important in patients at high risk: those with sickle cell disease, rebleeding, and elevated intraocular pressure. Cataract is a common complication in eyes sustaining serious trauma, although its presence may be difficult to confirm during the initial repair. The diagnosis is especially crucial because of the significantly increased risk of endophthalmitis. If the surgeon is able to determine that cataract is indeed present and hinders visualization of the posterior segment, or may lead to rapid elevation of the intraocular pressure, primary lens removal should be considered because vitreoretinal injuries are expected in approximately one-half of eyes, and an early retinal examination is mandatory in all eyes with lens trauma. Because one out of two eyes have posterior capsule injury, vitrectomy methods of lens removal are commonly required. Preservation of the posterior capsule is less important than avoiding traction on the anterior vitreous, because alternative methods of intraocular lens placement offer similar functional results.
由于外伤在前房出现的物质可能意义不大或具有重大意义。最常见的需要治疗的发现是前房积血。密切观察和（通常是手术）治疗在高危患者中尤为重要：镰状细胞病患者、再出血患者和眼压升高患者。白内障是严重眼外伤后的常见并发症，尽管在初次修复期间可能难以确认其存在。由于眼内炎的风险显著增加，诊断尤为关键。如果外科医生能够确定确实存在白内障且妨碍了对后节的观察，或者可能导致眼压迅速升高，则应考虑一期晶状体摘除，因为大约一半的眼预计会有玻璃体视网膜损伤，并且所有有晶状体损伤的眼都必须尽早进行视网膜检查。由于每两只眼中有一只有后囊损伤，通常需要采用玻璃体切割术摘除晶状体。保留后囊不如避免对前部玻璃体的牵拉重要，因为人工晶状体植入的替代方法能提供相似的功能结果。
